CPT 72193
The standard charge for CT scan, pelvis, with contrast is $1,966.00. However, the price you pay depends on the rate negotiated by your insurance plan and what portion your insurance plan requires you to contribute towards that amount. Enter your info below to start your estimate.
To calculate an estimate of your cost, you will need two things:
LOCATION
321 Madison St., Sheridan, MT, 59749CONTACT
(406) 842-5453 Visit WebsiteRuby Valley Medical Center is committed to empowering our patients to make informed decisions about their healthcare. This includes helping patients understand the cost of care and the availability of financial assistance.
In compliance with federal law, Ruby Valley Medical Center provides a list of standard charges. These are reviewed on an annual basis. Charges for hospital services are not equivalent to the actual amount paid by insurance companies or patients. The amount paid for services is based on many factors, including health insurance benefit plans, applicable discounts, and services provided based on each patient’s unique needs.
I understand that the list of standard charges includes only hospital services and does not contain professional fees for non-Ruby Valley Medical Center physicians or advanced practice providers. It does not contain professional fees for anesthesia, physicians or advanced practice providers.
I understand that a single line item charge may not represent a complete medical service. In general, multiple charge line items are necessary to represent all components of a service (e.g. procedures, supplies, and drugs).
I understand that the list of standard charges is not intended for media use.
I understand prices are the list price of all hospital charges and not necessarily what my insurance company will pay or what I will owe to the hospital. My actual bill may include one or more of list price charges.
The hospital typically accepts a rate that is less than the list charges. Your insurer will determine what you will owe after they have paid their agreed upon amount.
We know that the billing and payment processes may seem overwhelming at times. Please contact our team at 406-842-5453 or via our contact form here.
Choose a plan to view the insurance rate estimate.
Total estimated charges
$1,966.00Insurance Discount
-$98.30Price Negotiated by Insurer
$1,867.70Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
.COMPLETE BLOOD COUNT, WITH AUTO DIFF
$101.65COMPREHENSIVE METABOLIC PANEL
$204.25C-REACTIVE PROTEIN
$86.45CT CONTRAST BOTTLE ISOVUE 250 200ML
$171.95IV INFUSION THERAPY INIT SET UP 1.5 HR
$389.50LAB VENIPUNCTURE
$23.75LACTASE CHEW TAB [9000 FCC UNITS]
$4.75LACTIC ACID
$135.85NS 100mL Charge only
$8.55OPO DIRECT ADMISSION
$176.70OPO PER HOUR 2 OR MORE
$46.55SUPPLIES
$7.60This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Ruby Valley Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Ruby Valley Medical Center directly.
Total estimated charges
$1,966.00Insurance Discount
-$196.60Price Negotiated by Insurer
$1,769.40Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
.COMPLETE BLOOD COUNT, WITH AUTO DIFF
$96.30COMPREHENSIVE METABOLIC PANEL
$193.50C-REACTIVE PROTEIN
$81.90CT CONTRAST BOTTLE ISOVUE 250 200ML
$162.90IV INFUSION THERAPY INIT SET UP 1.5 HR
$369.00LAB VENIPUNCTURE
$22.50LACTASE CHEW TAB [9000 FCC UNITS]
$4.50LACTIC ACID
$128.70NS 100mL Charge only
$8.10OPO DIRECT ADMISSION
$167.40OPO PER HOUR 2 OR MORE
$44.10SUPPLIES
$7.20This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Ruby Valley Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Ruby Valley Medical Center directly.
Total estimated charges
$1,966.00Insurance Discount
-$196.60Price Negotiated by Insurer
$1,769.40Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
.COMPLETE BLOOD COUNT, WITH AUTO DIFF
$96.30COMPREHENSIVE METABOLIC PANEL
$193.50C-REACTIVE PROTEIN
$81.90CT CONTRAST BOTTLE ISOVUE 250 200ML
$162.90IV INFUSION THERAPY INIT SET UP 1.5 HR
$369.00LAB VENIPUNCTURE
$22.50LACTASE CHEW TAB [9000 FCC UNITS]
$4.50LACTIC ACID
$128.70NS 100mL Charge only
$8.10OPO DIRECT ADMISSION
$167.40OPO PER HOUR 2 OR MORE
$44.10SUPPLIES
$7.20This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Ruby Valley Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Ruby Valley Medical Center directly.
Total estimated charges
$1,966.00Insurance Discount
-$98.30Price Negotiated by Insurer
$1,867.70Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
.COMPLETE BLOOD COUNT, WITH AUTO DIFF
$101.65COMPREHENSIVE METABOLIC PANEL
$204.25C-REACTIVE PROTEIN
$86.45CT CONTRAST BOTTLE ISOVUE 250 200ML
$171.95IV INFUSION THERAPY INIT SET UP 1.5 HR
$389.50LAB VENIPUNCTURE
$23.75LACTASE CHEW TAB [9000 FCC UNITS]
$4.75LACTIC ACID
$135.85NS 100mL Charge only
$8.55OPO DIRECT ADMISSION
$176.70OPO PER HOUR 2 OR MORE
$46.55SUPPLIES
$7.60This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Ruby Valley Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Ruby Valley Medical Center directly.
Total estimated charges
$1,966.00Insurance Discount
-$196.60Price Negotiated by Insurer
$1,769.40Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
.COMPLETE BLOOD COUNT, WITH AUTO DIFF
$96.30COMPREHENSIVE METABOLIC PANEL
$193.50C-REACTIVE PROTEIN
$81.90CT CONTRAST BOTTLE ISOVUE 250 200ML
$162.90IV INFUSION THERAPY INIT SET UP 1.5 HR
$369.00LAB VENIPUNCTURE
$22.50LACTASE CHEW TAB [9000 FCC UNITS]
$4.50LACTIC ACID
$128.70NS 100mL Charge only
$8.10OPO DIRECT ADMISSION
$167.40OPO PER HOUR 2 OR MORE
$44.10SUPPLIES
$7.20This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Ruby Valley Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Ruby Valley Medical Center directly.
Total estimated charges
$1,966.00Insurance Discount
-$196.60Price Negotiated by Insurer
$1,769.40Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
.COMPLETE BLOOD COUNT, WITH AUTO DIFF
$96.30COMPREHENSIVE METABOLIC PANEL
$193.50C-REACTIVE PROTEIN
$81.90CT CONTRAST BOTTLE ISOVUE 250 200ML
$162.90IV INFUSION THERAPY INIT SET UP 1.5 HR
$369.00LAB VENIPUNCTURE
$22.50LACTASE CHEW TAB [9000 FCC UNITS]
$4.50LACTIC ACID
$128.70NS 100mL Charge only
$8.10OPO DIRECT ADMISSION
$167.40OPO PER HOUR 2 OR MORE
$44.10SUPPLIES
$7.20This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Ruby Valley Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Ruby Valley Medical Center directly.
Total estimated charges
$1,966.00Insurance Discount
-$98.30Price Negotiated by Insurer
$1,867.70Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
.COMPLETE BLOOD COUNT, WITH AUTO DIFF
$101.65COMPREHENSIVE METABOLIC PANEL
$204.25C-REACTIVE PROTEIN
$86.45CT CONTRAST BOTTLE ISOVUE 250 200ML
$171.95IV INFUSION THERAPY INIT SET UP 1.5 HR
$389.50LAB VENIPUNCTURE
$23.75LACTASE CHEW TAB [9000 FCC UNITS]
$4.75LACTIC ACID
$135.85NS 100mL Charge only
$8.55OPO DIRECT ADMISSION
$176.70OPO PER HOUR 2 OR MORE
$46.55SUPPLIES
$7.60This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Ruby Valley Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Ruby Valley Medical Center directly.
Total estimated charges
$1,966.00Insurance Discount
$0.00Price Negotiated by Insurer
$1,966.00Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
.COMPLETE BLOOD COUNT, WITH AUTO DIFF
$107.00COMPREHENSIVE METABOLIC PANEL
$215.00C-REACTIVE PROTEIN
$91.00CT CONTRAST BOTTLE ISOVUE 250 200ML
$181.00IV INFUSION THERAPY INIT SET UP 1.5 HR
$410.00LAB VENIPUNCTURE
$25.00LACTASE CHEW TAB [9000 FCC UNITS]
$5.00LACTIC ACID
$143.00NS 100mL Charge only
$9.00OPO DIRECT ADMISSION
$186.00OPO PER HOUR 2 OR MORE
$49.00SUPPLIES
$8.00This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Ruby Valley Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Ruby Valley Medical Center directly.
Total estimated charges
$1,966.00Insurance Discount
-$196.60Price Negotiated by Insurer
$1,769.40Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
.COMPLETE BLOOD COUNT, WITH AUTO DIFF
$96.30COMPREHENSIVE METABOLIC PANEL
$193.50C-REACTIVE PROTEIN
$81.90CT CONTRAST BOTTLE ISOVUE 250 200ML
$162.90IV INFUSION THERAPY INIT SET UP 1.5 HR
$369.00LAB VENIPUNCTURE
$22.50LACTASE CHEW TAB [9000 FCC UNITS]
$4.50LACTIC ACID
$128.70NS 100mL Charge only
$8.10OPO DIRECT ADMISSION
$167.40OPO PER HOUR 2 OR MORE
$44.10SUPPLIES
$7.20This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Ruby Valley Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Ruby Valley Medical Center directly.
Total estimated charges
$1,966.00Insurance Discount
-$98.30Price Negotiated by Insurer
$1,867.70Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
.COMPLETE BLOOD COUNT, WITH AUTO DIFF
$101.65COMPREHENSIVE METABOLIC PANEL
$204.25C-REACTIVE PROTEIN
$86.45CT CONTRAST BOTTLE ISOVUE 250 200ML
$171.95IV INFUSION THERAPY INIT SET UP 1.5 HR
$389.50LAB VENIPUNCTURE
$23.75LACTASE CHEW TAB [9000 FCC UNITS]
$4.75LACTIC ACID
$135.85NS 100mL Charge only
$8.55OPO DIRECT ADMISSION
$176.70OPO PER HOUR 2 OR MORE
$46.55SUPPLIES
$7.60This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Ruby Valley Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Ruby Valley Medical Center directly.
Total estimated charges
$1,966.00Insurance Discount
-$196.60Price Negotiated by Insurer
$1,769.40Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
.COMPLETE BLOOD COUNT, WITH AUTO DIFF
$96.30COMPREHENSIVE METABOLIC PANEL
$193.50C-REACTIVE PROTEIN
$81.90CT CONTRAST BOTTLE ISOVUE 250 200ML
$162.90IV INFUSION THERAPY INIT SET UP 1.5 HR
$369.00LAB VENIPUNCTURE
$22.50LACTASE CHEW TAB [9000 FCC UNITS]
$4.50LACTIC ACID
$128.70NS 100mL Charge only
$8.10OPO DIRECT ADMISSION
$167.40OPO PER HOUR 2 OR MORE
$44.10SUPPLIES
$7.20This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Ruby Valley Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Ruby Valley Medical Center directly.
Total estimated charges
$1,966.00Insurance Discount
-$157.28Price Negotiated by Insurer
$1,808.72Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
.COMPLETE BLOOD COUNT, WITH AUTO DIFF
$98.44COMPREHENSIVE METABOLIC PANEL
$197.80C-REACTIVE PROTEIN
$83.72CT CONTRAST BOTTLE ISOVUE 250 200ML
$166.52IV INFUSION THERAPY INIT SET UP 1.5 HR
$377.20LAB VENIPUNCTURE
$23.00LACTASE CHEW TAB [9000 FCC UNITS]
$4.60LACTIC ACID
$131.56NS 100mL Charge only
$8.28OPO DIRECT ADMISSION
$171.12OPO PER HOUR 2 OR MORE
$45.08SUPPLIES
$7.36This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Ruby Valley Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Ruby Valley Medical Center directly.
Total estimated charges
$1,966.00Insurance Discount
-$589.80Price Negotiated by Insurer
$1,376.20Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
.COMPLETE BLOOD COUNT, WITH AUTO DIFF
$74.90COMPREHENSIVE METABOLIC PANEL
$150.50C-REACTIVE PROTEIN
$63.70CT CONTRAST BOTTLE ISOVUE 250 200ML
$126.70IV INFUSION THERAPY INIT SET UP 1.5 HR
$287.00LAB VENIPUNCTURE
$17.50LACTASE CHEW TAB [9000 FCC UNITS]
$3.50LACTIC ACID
$100.10NS 100mL Charge only
$6.30OPO DIRECT ADMISSION
$130.20OPO PER HOUR 2 OR MORE
$34.30SUPPLIES
$5.60This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Ruby Valley Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Ruby Valley Medical Center directly.
Total estimated charges
$1,966.00Insurance Discount
-$98.30Price Negotiated by Insurer
$1,867.70Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
.COMPLETE BLOOD COUNT, WITH AUTO DIFF
$101.65COMPREHENSIVE METABOLIC PANEL
$204.25C-REACTIVE PROTEIN
$86.45CT CONTRAST BOTTLE ISOVUE 250 200ML
$171.95IV INFUSION THERAPY INIT SET UP 1.5 HR
$389.50LAB VENIPUNCTURE
$23.75LACTASE CHEW TAB [9000 FCC UNITS]
$4.75LACTIC ACID
$135.85NS 100mL Charge only
$8.55OPO DIRECT ADMISSION
$176.70OPO PER HOUR 2 OR MORE
$46.55SUPPLIES
$7.60This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Ruby Valley Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Ruby Valley Medical Center directly.
Total estimated charges
$1,966.00Insurance Discount
-$58.98Price Negotiated by Insurer
$1,907.02Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
.COMPLETE BLOOD COUNT, WITH AUTO DIFF
$103.79COMPREHENSIVE METABOLIC PANEL
$208.55C-REACTIVE PROTEIN
$88.27CT CONTRAST BOTTLE ISOVUE 250 200ML
$175.57IV INFUSION THERAPY INIT SET UP 1.5 HR
$397.70LAB VENIPUNCTURE
$24.25LACTASE CHEW TAB [9000 FCC UNITS]
$4.85LACTIC ACID
$138.71NS 100mL Charge only
$8.73OPO DIRECT ADMISSION
$180.42OPO PER HOUR 2 OR MORE
$47.53SUPPLIES
$7.76This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Ruby Valley Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Ruby Valley Medical Center directly.
Total estimated charges
$1,966.00Insurance Discount
-$98.30Price Negotiated by Insurer
$1,867.70Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
.COMPLETE BLOOD COUNT, WITH AUTO DIFF
$101.65COMPREHENSIVE METABOLIC PANEL
$204.25C-REACTIVE PROTEIN
$86.45CT CONTRAST BOTTLE ISOVUE 250 200ML
$171.95IV INFUSION THERAPY INIT SET UP 1.5 HR
$389.50LAB VENIPUNCTURE
$23.75LACTASE CHEW TAB [9000 FCC UNITS]
$4.75LACTIC ACID
$135.85NS 100mL Charge only
$8.55OPO DIRECT ADMISSION
$176.70OPO PER HOUR 2 OR MORE
$46.55SUPPLIES
$7.60This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Ruby Valley Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Ruby Valley Medical Center directly.
Total estimated charges
$1,966.00Insurance Discount
-$98.30Price Negotiated by Insurer
$1,867.70Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
.COMPLETE BLOOD COUNT, WITH AUTO DIFF
$101.65COMPREHENSIVE METABOLIC PANEL
$204.25C-REACTIVE PROTEIN
$86.45CT CONTRAST BOTTLE ISOVUE 250 200ML
$171.95IV INFUSION THERAPY INIT SET UP 1.5 HR
$389.50LAB VENIPUNCTURE
$23.75LACTASE CHEW TAB [9000 FCC UNITS]
$4.75LACTIC ACID
$135.85NS 100mL Charge only
$8.55OPO DIRECT ADMISSION
$176.70OPO PER HOUR 2 OR MORE
$46.55SUPPLIES
$7.60This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Ruby Valley Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Ruby Valley Medical Center directly.